From Standard to Transumbilical Laparoscopic Cholecystectomy – Learning Curve and Preliminary Results

Bakcground: Laparoscopic cholecystectomy (LC) is generally accepted as a standard treatment of cholelythiasis. However there are trends to further minimize surgical trauma and to improve cosmetic results by performing LC through a single transumbilical incision. The aim of this study was to evaluate the learning curve and early results of transumbilical laparoscopic cholecystectomy (TC) performed by a single surgical team. Patients and methods: between April’2009 and March’2010 52 consecutive patients with gallbladder diseases were operated by the same team using previously published original modification of the surgical technique. Results: TC was performed in 48 unselected consecutive patients. The mean age of the patients was 52yrs, 65% of the patients were females. According to the diagnosis 36 (75%) patients had chronic cholecystitis and 12 (25%) had acute cholecystitis. There were 2 (4%) conversions to standard LC and a single conversion to laparotomy (2%). The mean operating time was 79 min (range 40-120 min). Conclusion: TC can safely and rapidly replace standard LC in everyday surgical practice. The conversion rate of TC is comparable with the standard LC, but the operating time is still longer in TC.